Online ISSN: 2515-8260

Keywords : Gestational Diabetes Mellitus


A clinical study of maternal and neonatal outcome in pregnant women with obesity (BMI more than 30) at a tertiary hospital

Dr. Anurag Sonawane, Dr. Shrinivas Gadappa, Dr. Sandeep S Mannikatti, Dr. Rupali A Gaikwad .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1123-1129

Background: Obesity is one such pre-existing maternal morbidity that puts a pregnancy at risk. Maternal obesity is a frequent high-risk factor with substantial prenatal, intranasally, and postnatal problems. This study aimed to analyze maternal and fetal outcome in obese pregnant women (BMI more than 30) at our tertiary care teaching hospital.
Material and Methods: This study was prospective & observational study, conducted in pregnant women, gestational age > 28 weeks, with BMI > 30, delivering at our labour room. Maternal and neonatal outcomes were analysed.
Results: Among 453 pregnant women with BMI > 30kg/m2, majority were from 19—25 years age group (45.1 %), 48.03% were primigravida, 82.33% had > 37 weeks of gestation. In the study group 78.43% were moderately obese, 15.69% were severely obese and only 5.88% were morbidly obese. Most common pre pregnancy medical disorder in obese women were preeclampsia (21.57 %), previous LSCS (20.59 %), severe anaemia (19.54 %), gestational diabetes mellitus (12.75 %), gestational hypertension (9.80 %) & multiple pregnancy (1.96 %). Common intrapartum events were Preterm labor (16.67 %), PPH (6.78 %), Abruptio placenta (4.90 %), Mal presentation Breech (4.90%) & Eclampsia(1.96%).63.71%of obese pregnant women delivered by normal vaginal delivery, 31.37% of obese pregnant women underwent cesaerian section & 4.90% of obese women were requiring instrumental delivery. Common indication for NICU admission were infant of diabetic mother (22.55 %), preterm (14.71 %), meconium aspiration (5.88 %), macrosomia (3.92 %), asphyxia (1.96 %) & transient tachypnia of new born (1.96%). No maternal or neonatal mortality observed in present study.
Conclusion: In obese pregnant women with BMI >30kg/m2, higher incidence of gestational hypertension, preeclampsia, gestational diabetes mellitus, anaemia, malpresentation, cephalopelvic disproportions and hypothyroidism isnoted,

Maternal and Perinatal Outcome in Gestational Diabetes Mellitus at a Tertiary Care Centre

Dr.Prashant Bhingare, Dr. Shrinivas Gadappa,Dr.Deoyani Wakde, Dr.RosyIalhriatpuii .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2570-2578

Aim of study: To study Clinically Maternal and Perinatal Outcome in Gestational Diabetes Mellitus at a Tertiary Care Centre.
Material & Methods: A Prospective observational study was conducted inthe labour room , Depatment of Obstetrics and Gynecology at a  tertiary care hospital , during 1st October 2019 to 30th September 2021. In this study we enrolled 120 cases during two years. All pregnant women diagnosed as GDM and delivering in our hospital were included.
Observation & Results: 47(39.17%) pregnantwomen with GDM were from age-group of 21-25 years. Majority of the cases of GDM i.e.34(28.3%) were associated withDiabetes in first degree relatives. Most frequent antepartum maternal complication seen was pre-term found in 32 (26.7%). In intrapartum, 3(2.5%) pregnant women were foundto have Cervical Tear and postpartum, Post operative wound infection (Purpural Sepsis) was observed in 3(2.5%)  pregnant women and 07(5.8%) had Postpartum hemorrhage. Most frequent maternal complication in  pregnant women with GDMwhich was observed wasPreterm labour i.e. 32(26.7%). Among foetal complications , maximum i.e.  in 11(9,2%) GDM pregnant women, Intrauterine foetal death was observed and 02(1.7%) were IUGR and 01(0.83) reported Shoulder Dystocia. 14(11.7%) pregnant women reported perinatal mortality.
Conclusion: Screening for GDM should be done at the first antenatal visit. Precise control of blood sugar right from the beginning of pregnancy assures a good maternal and neonatal outcome. Gestational Diabetes Mellitus is a high risk pregnancy and should be delivered at a tertiary care centre or a centre equipped with all the facilities needed.

ASSOCIATION OF DUAL ENDOCRINOPATHY WITH SEVERITY OF PREECLAMPSIA - A PROSPECTIVE OBSERVATIONAL STUDY

Sudhaa Sharma; Natasha Gupta; Sunita Jamwal; Atul Sharma

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1867-1877

Introduction: Hypertensive disorders complicate 5-10 percent of all pregnancies and contributes greatly to maternal and fetal morbidity and mortality. Women with gestational diabetes are at increased risk of preeclampsia and worsens the fetal prognosis. Thyroid hormones seem to be important in placentation and regulation of early pregnancy, partly explaining the association between hypothyroidism and preeclampsia. Incidence of both hypothyroidism and gestational diabetes was found significantly higher in women with Preeclampsia Induced Hypertension. There are few studies worldwide to establish the association between Preeclampsia, gestational diabetes mellitus and hypothyroidism in pregnancy. Objective: The objective of this study was to determine the association of dual endocrinopathy in pregnancy with severity of preeclampsia. Study Design: Prospective Observational Cross-sectional Study Material and Methods: 400 patients who met inclusion criteria and consented for the study were recruited in the study from November 2015 to October 2016 in the Department of Obstetrics and Gynaecology , SMGS Hospital, Govt Med College Jammu. All patients underwent relevant blood and urine tests. They were grouped into 2 groups – mild and severe preeclampsia. The association of two groups with dual endocrinopathy (hypothyroidism and gestational diabetes mellitus) was studied. Statistical analysis: Chi-square test was employed to determine association of dual endocrinopathy with severity of preeclampsia. P-value less than 0.05 was considered statistically significant. Results: In this study, majority of patients i.e. 70.50% (282 out of 400) were in the mild preeclampsia group and only 29.50% (118 out of 400) were in the severe preeclampsia group. According to present study, 14.4 % of severe preeclampsia patients had dual endocrinopathy while only 7.8 % of mild preeclampsia patients had dual endocrinopathy. This association was calculated using Chi-Square Test and was statistically significant (P value = 0.042).

Risk Factors for Cesarean Delivery in Patients of Gestational Diabetes Mellitus at a Tertiary Care Centre - A Descriptive Observational Study

Dr. Saba Musharaf; Dr. Sabha Malik; Dr. Natasha Gupta

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 8146-8152

Introduction Gestational diabetes mellitus (GDM) is one of the most frequent metabolic disorders during pregnancy, with incidence rates ranging from 1.1% to 14.3%. It is important to identify which risk factors may lead to a cesarean delivery, so to plan the procedure in advance and to avoid possible complications for both the mother and the fetus. Therefore this study was conducted to identify the risk factors associated with cesarean section in pregnant women with GDM. Objective : To identify the risk factors associated with cesarean section in pregnant women with GDM Study Design: This was a descriptive observational study conducted in a tertiary care centre over a period of 1 year from January 2018 to December 2018 at SKIMS, Soura, Srinagar, Kashmir Material & Methods: 100 patients of Gestational Diabetes Mellitus were recruited and mode of delivery and various risk factors associated with cesarean delivery were evaluated Results: Among the patients of GDM, who underwent LSCS & NVD, mean age was significantly more (30.8±3.75 years & 28.4±3.42 years respectively, p value -0.010) in LSCS group. BMI was significantly higher in GDM patients who underwent LSCS as compared to patients who underwent NVD (29.7±2.49 kg/m² vs 25.3±1.98 kg/m², p value <0.001). Blood sugar fasting and postprandial values were significantly higher in patients of GDM who underwent LSCS as compared to patients who underwent NVD [ BS(F) - 99±14.11 g/dl vs 87.6±7.51 g/dl, p value <0.001; BS(PP) - 127.7±30.79 g/dl vs 87.6±7.51 g/dl, p value - 0.041]. Prior cesarean section was also an independent risk factor in deciding mode of delivery in patients of GDM. Among the patients who underwent LSCS, maximum were on insulin (56%) followed by diet (33.3%). Among group B (NVD), maximum patients were on diet (56%) followed by metformin (24%) Conclusion: The mean age of patients and BMI was higher in patients who underwent cesarean section (p - 0.010 and < 0.001 respectively). High blood sugar levels (fasting and postprandial), primigravida and prior cesarean section were associated with high chances of cesarean section (p < 0.001, 0.041, 0.007 and 0.001 respectively). There were no significant difference between the 2 groups in regards to gestational age at delivery, the weight of newborn and the apgar score at 1 and 5 minutes after birth.

An individual approach to the management of gestational diabetes

Gulrux K. . Karimova; Nilufar O. Navruzova; Shahodat N. Nurilloyeva

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 6284-6291

Objective: Selection of an effective method of delivery for mother and child in pregnant women with gestational diabetes. The retrospective group included 67 women who passed through the regional perinatal center, city maternity complex and family clinics No. 5, No. 6 of the city of Bukhara in the periods from 2016 to 2018. The main (prospect) group consisted of 68 women whose pregnancy proceeded against the background of overt or gestational diabetes mellitus (GDM). The control group consisted of 36 women whose pregnancy proceeded physiologically. As a result of the study, the course of pregnancy and childbirth according to the history of childbirth and own observations revealed that in all (60%) pregnant women with GDM, pregnancy and childbirth proceeded with any complications, like in the mother and the fetus. Thus, pregnancy proceeded against the background of corrected diabetes with the use of the optimal insulin regimen and rational diet therapy, the absence of signs of diabetic fetopathy, then in this category of pregnant women, the delivery through the birth canal is considered the best option.